Expression of Interest Form: NT Farm Business Resilience Program including Farm Water Use Efficiency -

Even if the proposed dates and / or locations don't currently suit you, please fill in this form and we will be in touch to chat further.

Name:*

First NameLast Name

E-mail Address:

example@example.com

Phone Number

Area CodePhone Number

Mobile Phone Number

Choose your preferred location (please note that these locations may change)

ALICE SPRINGSTENNANT CREEKKATHERINE

If the above dates and locations currently don't suit you, please tell us your preference/s.

Number of participants from your business who will attend

Address:*

Property Name/s

Street Address

CityState / Province

Postal / Zip Code

What is your nearest main town

Postal Address

Include Post Code

Describe your enterprise mix?*

What is the size of your operation in hectares?

How did you hear about the NT Farm Business Resilience Program

Value Creators WebsiteValue Creators direct email or phone callNorthern Territory GovernmentThe Northern HubSocial Media (Facebook, Twitter, Instagram, LinkedIn etc)Print Media or Radio (NT News, ABC etc)Word of Mouth (neighbour, friend, family)Industry Association (NT Farmers, NT Cattleman's Association, MLA, Territory NRM etc)

Value Creators Data Collection Statement

Value Creators respects and is committed to safeguarding the confidentiality and privacy of the information that it collects and handles, in accordance with the Northern Territory Information Act 2002.

You have been asked to provide personal information, which is necessary for us to contact you, so that we can provide important information relating to the program delivery, logistics, mentoring and any urgent messaging. You do not have to provide your personal information but if you choose not to, we will not be able to contact you about the Farm Business Resilience Program, including Farm Water Use Efficiency and other programs.

The information you provide will be accessible to Value Creators and will be treated with the utmost confidence and will only be used to provide a service or program. We will not disclose your personal information to third parties unless:

authorised or required by law to do so
you have given us your consent to share your personal information for a specific purpose
You may request access to the personal information we hold about you.

If you want more information about the Northern Territory’s privacy laws, please refer to the Northern Territory Information Act 2002, or the Office of the Information Commissioner NT.

EXPRESSION OF INTEREST FORM

Northern Territory Farm Business Resilience Program - including Farm Water Use Efficiency

Thank you for expressing your interest in the upcoming NT Farm Business Resilience Program. We look forward to working with you.